07 occlusal therapy

Question 1

What is a risk factor?

Answer 1

an environmental, behavioral, or biological factor that has been ASSOCIATED with the disease

Question 2

what are the two criteria for a risk factor?

Answer 2

• biologically plausible as a causal agent for disease

- precede development of disease

Question 3

what is the difference between a systemic and a local risk factor?

Answer 3

• systemic: impacting the “whole” patient. ex genetics, smoking
• local: impacting a tooth or a site, ex: excessive occlusal force on tooth

Question 4

what is physiologic occlusion?

Answer 4

• an occlusion that operates in harmony
• presents no pathologic manifestation in the supporting structures of the teeth
• stresses placed on the teeth are dissipated normally, with a balance existing between the stresses and adaptive capacity of the supporting tissue

Question 5

what is non-physiologic occlusion?

Answer 5

• an occlusion that does not operate in harmony
• pathologic manifestation in the supporting structures of the teeth
• stresses placed on the teeth are not dissipated normally, without a balance existing between the stresses and adaptive capacity of the supporting tissues

Question 6

what is the response to excessive forces in tissue?

Answer 6

• blood vessels enlarge, PDL fibers disorganize, collagen destroyed, osteoclasts predominate
• resorption of the alveolar bone at pressure zone
• widening of PDL space
• tooth mobility

Question 7

what is the adaptive response of the tissue to excessive forces?

Answer 7

-the adaptive response manifests as widening of the socket and PDL, allowing movement of the tooth away from the traumatic force

Question 8

relationship of excessive occlusal forces and periodontal disease

Answer 8

Excessive occlusal forces DO NOT INITIATE perio disease

• may contribute to the progression of pd disease
• not capable of initiating inflammation or pocket formation in the absence of bacterial plaque nor will it increase gingivitis
• “Co-destructive factors” theory

Question 9

what kind of risk factor is “excessive occlusal force”

Answer 9

-local risk factor

Question 10

what is fremitus?

Answer 10

palpable or visible movement of a tooth when subject to occlusal forces
-FUNCTIONAL MOBILITY

Question 11

what are the reasons for tooth mobility?

Answer 11

1. inflammation within the PDL, endodonic or periodontic reasons
2. bone loss
3. trauma

Question 12

what is the “hallmark” of occlusal trauma?

Answer 12

tooth mobility, can be functional, or non-functional

Question 13

primary occlusal trauma

Answer 13

injury resulting in tissue changes from excessive occlusal forces applied to a tooth or teeth with normal support
-occurs in the presence of normal bone levels and attachment, and excessive occlusal forces

Question 14

secondary occlusal trauma

Answer 14

• injury resulting in tissue changes from normal or excessive occlusal forces applied to a tooth or teeth with reduced support
• occurs in the presence of bone loss, attachment loss and NORMAL or excessive occlusal forces

Question 15

what are the different types of occlusal therapies?

Answer 15

• occlusal adjustmnet
• splinting (bite splint, coronal splinting)
• restorative procedures
• ortho
• orthognathic surgery

Question 16

occlusal adjustment

Answer 16

• coronoplasty

- adjustment of the occlusla contacts to create more stability in co and other positions

Question 17

coronal splinting

Answer 17

fixed appliance (made of resin or wire) that is bonded/cemented to teeth
-reduces mobility, although, the mobility is only reduced while bonded, if the splint is taken off, loose teeth from before will still be loose